颈动脉超声对锁骨下动脉盗血综合征患者健侧椎动脉的血流动力学评估

Hemodynamic evaluation of contralateral vertebral artery in patients with subclavian steal syndrome by carotid ultrasound

目的:探讨不同类型锁骨下动脉盗血综合征(SSS)患者健侧椎动脉(VA)血流动力学变化的超声特征。方法:回顾性连续纳入颈动脉超声诊断并经CT血管成像证实为动脉粥样硬化性SSS者152例为研究组,将152例SSS患者分为Ⅰ型即隐匿型盗血者47例,Ⅱ型即部分型盗血者60例和Ⅲ型即完全型盗血者45例,同期健康体检中心排除心脑血管疾病者46例为对照组,分析不同盗血类型患者健侧VA的管径及血流动力学改变,并与对照组比较。结果:研究组中3种类型SSS健侧VA血流动力学参数分别与对照组比较,Ⅰ型与对照组比较差异无统计学意义(P>0.05),Ⅱ型、Ⅲ型分别与对照组比较差异具有统计学意义(P<0.05);不同盗血类型的健侧VA管径及血流动力学参数随盗血程度的加重而增加(P<0.05)。结论:应用颈动脉超声检查SSS患者健侧VA血流动力学参数可用于初步评估锁骨下动脉病变及其VA-VA盗血通路。

Objective:To investigate the ultrasonographic characteristics of the hemodynamic changes of the contralateral vertebral artery(VA)in patients with different types of subclavian steal syndrome(SSS).Methods:A total of 152 cases of SSS diagnosed by carotid Doppler ultrasonography and confirmed by CT angiography were enrolled as the study group.These 152 cases of SSS were divided into typeⅠ(47 cases of occult steal blood),typeⅡ(60 cases of partial steal blood)and typeⅢ(45 cases of complete steal blood).Meanwhile,46 cases without cardiovascular and cerebrovascular diseases from the Health Examination Center were taken as the control group.The diameter and hemodynamic changes of VA in healthy side of patients with different types of steal blood were analyzed and compared with the control group.Results:The hemodynamic parameters of VA on the contralateral side of three types of SSS in the study group were compared with those in the control group,there was no significant difference between typeⅠand the control group(P>0.05),and there was significant difference between typeⅡand typeⅢand the control group(P<0.05).The diameter and hemodynamic parameters of VA were increased with the severity of steal blood(P<0.05).Conclusions:Examination of VA hemodynamic parameters in healthy side of SSS patients by carotid Doppler ultrasonography can be used to preliminarily evaluate subclavian artery lesions and VA-VA steal pathway.